Orthoviorthovisc For Shoulder – Is It a Good Treatment?

Last Updated On: September 17, 2024

Studies show that hyaluronic acid (HA) injections can significantly reduce pain and improve joint function in patients with shoulder osteoarthritis (OA). By delivering HA directly into the joint, these injections help to lubricate and cushion the area, enhancing movement and reducing discomfort.

Orthovisc, a high-molecular-weight hyaluronic acid injection, is commonly used to treat knee OA and is now being used off-label for shoulder OA due to its effectiveness. This treatment aims to provide lasting relief by improving joint lubrication and reducing inflammation.

This article will explore the benefits and potential drawbacks of using Orthovisc for shoulder OA, compare it to other treatment options, and discuss what patients can expect from this therapy.

Key Takeaways

• Shoulder osteoarthritis (OA) can significantly impact daily activities due to pain, stiffness, and decreased range of motion.
• Treatment options for shoulder OA include physical therapy, pain management, corticosteroid injections, lifestyle modifications, and surgical interventions, each with its own limitations.
• Orthovisc, a hyaluronic acid injection designed for knee OA, is being used off-label for shoulder OA and has shown promise in enhancing joint lubrication and cushioning.
• Studies suggest that Orthovisc injections can alleviate shoulder pain and improve mobility by reducing inflammation and enhancing joint lubrication.

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Understanding Shoulder Osteoarthritis and Treatment Options

Shoulder osteoarthritis (OA) is a degenerative joint condition characterized by the gradual breakdown of cartilage in the shoulder joint, particularly the glenohumeral (ball and socket) joint. This cartilage erosion leads to pain, stiffness, swelling, and decreased range of motion, making daily activities like lifting, reaching, or even sleeping difficult. OA in the shoulder can result from aging, previous injuries, or repetitive motion, significantly impacting the quality of life.

Treatment for shoulder OA typically begins with conservative methods aimed at managing pain and maintaining mobility. Common treatment options include:

• Physical Therapy: Exercises to strengthen shoulder muscles, improve flexibility, and enhance joint function.
• Pain Management: Over-the-counter pain relievers like acetaminophen or NSAIDs (e.g., ibuprofen) to reduce pain and inflammation.
• Corticosteroid Injections: Injections administered directly into the shoulder joint to reduce inflammation and provide temporary pain relief.
• Lifestyle Modifications: Changes such as avoiding heavy lifting and using supportive braces to minimize stress on the joint.
• Surgical Interventions: In severe cases, surgical options like shoulder arthroscopy, joint resurfacing, or total shoulder replacement may be considered.

While traditional treatments can manage symptoms, they have limitations. Pain medications offer short-term relief but pose risks like gastrointestinal and cardiovascular issues with long-term use. Corticosteroid injections provide temporary relief but may weaken tendons over time. Physical therapy and lifestyle changes improve function but may not fully alleviate pain or halt joint degradation, and surgery involves significant recovery time and risks.

Introduction to Orthovisc Injections for Shoulder Osteoarthritis

Orthovisc is a high-molecular-weight hyaluronic acid injection designed to relieve joint pain by mimicking the natural fluid found in healthy joints. Initially developed and FDA-approved for knee osteoarthritis, Orthovisc is now being used off-label to treat shoulder osteoarthritis due to its effectiveness in enhancing joint lubrication and cushioning.

Orthovisc injections work by delivering hyaluronic acid directly into the shoulder joint, restoring the viscosity of the synovial fluid. This added lubrication and shock absorption help reduce pain, improve mobility, and decrease inflammation by minimizing friction between the bones.

Although Orthovisc is not specifically FDA-approved for shoulder osteoarthritis, studies and patient feedback suggest it is a safe and effective off-label treatment. Many healthcare providers consider it a valuable non-surgical option, carefully monitoring its use to ensure patient safety and achieve the best possible results.

Efficacy of Orthovisc in Alleviating Shoulder Pain and Improving Joint Function

One review highlighted the use of high molecular weight hyaluronic acid, like Orthovisc, in treating various forms of osteoarthritis, including shoulder OA. The review emphasized that HA injections can alleviate pain and improve mobility by enhancing joint lubrication and reducing inflammation. This study suggests that Orthovisc is a promising treatment option for shoulder pain due to osteoarthritis, offering a potential alternative to traditional corticosteroid injections.

Patient Outcomes and Experiences

Patients have shared various feedback about this treatment. They find relief from shoulder pain after getting Orthovisc injections. 

• Shoul: “I have arthritis in both shoulders. It’s a wear-and-tear issue as I’m 68 and have been exercising fanatically for 50 years. My orthopedic doctor recommended Orthovisc injections, and I have had great results. I wholeheartedly recommend Orthovisc…”
• Rock: “…I have never had any discomfort during the procedure. I have also been diagnosed with ‘end-osteoarthritis’ in both shoulders and look forward to receiving the injections to either put an end to or reduce the pain that I experience.”

These points reflect diverse experiences with Orthovisc injections for shoulder issues, highlighting both its advantages and considerations before starting treatment.

Treatment Protocols and Considerations for Shoulder Injections

For treating shoulder osteoarthritis with Orthovisc, the typical protocol involves a series of injections. Generally, patients receive one injection per week for three to four weeks. Each injection contains 2 mL of Orthovisc, which is administered directly into the shoulder joint. This schedule helps to ensure that the hyaluronic acid builds up in the joint, providing sustained relief from pain and improving joint function.

Unique Considerations

Administering Orthovisc in the shoulder joint requires specific considerations to ensure efficacy and safety:

• Injection Technique: Proper injection technique is crucial. The healthcare provider must accurately locate the joint space to ensure the hyaluronic acid is delivered effectively.
• Patient Positioning: The patient should be comfortably positioned to allow easy access to the shoulder joint. This often involves the patient sitting or lying down with the arm slightly abducted.
• Ultrasound Guidance: Using ultrasound guidance can improve the accuracy of the injection, ensuring that the Orthovisc is delivered precisely into the joint space.
• Post-Injection Care: Patients are usually advised to avoid strenuous activities involving the shoulder for at least 48 hours post-injection to allow the medication to settle and reduce the risk of complications.

Potential Side Effects and Risks

While Orthovisc injections are generally well-tolerated, there are potential side effects and risks to consider:

• Injection Site Reactions: Common side effects include pain, swelling, and redness at the injection site. These reactions are typically mild and resolve within a few days.
• Infection: Although rare, there is a risk of infection at the injection site. Proper aseptic technique is essential to minimize this risk.
• Allergic Reactions: Some patients may experience allergic reactions to the injection’s hyaluronic acid or other components.
• Joint Pain: Patients may sometimes experience increased joint pain or stiffness following the injection. This is usually temporary and subsides with time.

Understanding these protocols and considerations can help healthcare providers optimize the use of Orthovisc for shoulder osteoarthritis, ensuring patients receive the maximum benefit from their treatment. Additionally, knowing the Orthovisc manufacturer can provide further confidence in the quality and reliability of the product.

Conclusion

Orthovisc offers a promising option for easing shoulder pain by enhancing joint lubrication, reducing friction, and improving mobility. While it is primarily approved for knee osteoarthritis, its off-label use for shoulder pain has shown effective results, providing patients with smoother, more comfortable movement.

Consulting with a healthcare provider is essential to determine if Orthovisc is a suitable treatment for your shoulder osteoarthritis and to ensure safe and effective use.

FAQs

1. What is Orthovisc, and how does it compare to other treatments such as Synvisc or Euflexxa?

Orthovisc, like Synvisc and Euflexxa, is a hyaluronic acid injection used to treat osteoarthritis by improving joint lubrication and cushioning, but they differ in their molecular weight and specific formulations.

2. How many Orthovisc injections are typically required for effective treatment? 

Typically, three to four Orthovisc injections, administered once a week, are required for effective treatment of osteoarthritis.

3. Is Orthovisc approved by the FDA? 

Yes, Orthovisc is approved by the FDA for the treatment of knee osteoarthritis.

References

Hyaluronic acid for osteoarthritis: Benefits and risks. www.medicalnewstoday.com. Published April 25, 2022. https://www.medicalnewstoday.com/articles/hyaluronic-acid-for-osteoarthritis 

Medical Treatment for Osteoarthritis of the Shoulder. nyulangone.org. https://nyulangone.org/conditions/osteoarthritis-of-the-shoulder/treatments/medical-treatment-for-osteoarthritis-of-the-shoulder